Cryptococcal Infection Combined with Cholesteatoma / 대한이비인후과학회지

Cryptococcus neoformans is a yeast-like organism causing opportunistic infection in the immunocompromized host. Men-ingitis is the most frequent manifestation and causes serious morbidity and mortality. Other sites are less commonly involved. There have been a few cases presenting hearing loss and vertigo as a result of the extension of meningitis through the internal auditory canal. Authors report a case of cryptococcal infection combined with cholesteatoma that developed in a 54-year-old woman who did not have either evidence of immunocompromised state or pathological signs of cryptococcal infection. Cryptococcus neoformans was incidentally found in the keratinized layer of cholesteatoma.

Evaluation of Regenerative Cell Kinetics of Rat Thyroid Gland by Immunohistochemical Staining of Proliferating Cell Nuclear Antigen and Bromodeoxyuridine / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Follicular cells of the thyroid gland has been considered an important factor affecting the thyroid gland regeneration.[(3)H]Thymidine autoradiography and immunohistochemical staining with BrdU have been commonly used and are reliable techniques for examining cell proliferation. However, these methods are not suitable for the routine analysis of cell proliferation kinetics, because they are fraught with problems such as needing fresh tissues and handling radioactive or toxic susbstances used as markers. The purpose of this study is to investigate the utility of immunohistochemical staining with a monoclonal antibody to PCNA during the healing process of a rat thyroid gland. We also compared this method with the immunohistochemical staining using a monoclonal antibody to BrdU. MATERIALS AND METHODS: We investigated the proliferative activity in regeneration of the partially resected rat thyroid tissue by using immunohistochemical stainings of PCNA and 5-bromo-2'-deoxyuridine (BrdU). The two methods were compared. RESULTS: Cell proliferative activity of regenerated follicular cells around the resected margin showed a continuous acceleration for 72 hours, and the PCNA-labeled cells stained the nuclei as clearly discernible as those of the BrdU-labeled cells. In addition, the immunohistochemical staining of PCNA provided reproducible and quantifiable results without the requirement of pretreatment. CONCLUSION: Immunohistochemical staining of PCNA and BrdU may represent as a useful technique for analysis of proliferative activity during regeneration of the thyroid glands in rats.

Polyostotic Fibrous Dysplasia with Cholesteatoma on External Auditory Canal and Mastoid / 대한이비인후과학회지

Fibrous dysplasia of temporal bone is a rare disease that may lead to progressive stenosis of external auditory canal. This stenosis leads to trapping of skin and development of cholesteatoma. Most cases with fibrous dysplasia of temporal bone are monostotic, and the polyostotic type is far more rare. We have experienced a recurred polyostotic fibrous dysplasia with cholesteatoma on the external auditory canal and the mastoid. Our purpose of this paper is to discuss properties and management of this rare disease. A twenty-one-year-old woman who had undergone canaloplasty for polyostotic fibrous dysplasia of right temporal bone and occipital bone 5 years ago returned complaining of intermittent right-sided otorrhea for one year. She underwent canal down mastoidectomy with tympanoplasty type 3 for recurred canal obstruction and developing cholesteatoma. The patient has been followed up regularly for one year. There is no evidence of the recurrence of the disease or associated symptoms. We emphasize the need for a long term follow-up of patients with this disease as cholesteatoma or restenosis may develop insidiously.

Relationship between the Extent of Fracture and the Degree of Enophthalmos in Isolated Blowout Fracture of the Medial Orbital Wall / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: In blowout fracture (BOF) of the medial orbital wall, the presence of significant enophthalmos indicates a need for surgery. In early post-traumatic period, it is usually difficult to measure the degree of enophthalmos due to orbital edema. So, in order to decide on the correct treatment method, it will be useful if we can predict the degree of enophthalmos according to the extent of fracture observed in computed tomography (CT). We studied the relationship between the extent of fracture measured in CT scans and the degree of enophthalmos in BOF of the medial orbital wall. MATERIALS AND METHODS: Nine patients with isolated BOF of the medial orbital wall confirmed by CT scans were studied. The severity of enophthalmos was measured by exophthalmometry. The area of fracture site and the volume of herniated orbital tissue were measured in CT scans. The statistical significance was analyzed using linear regression method. RESULTS: The degree of enophthalmos increased as the area of fracture site or the volume of herniated orbital tissue increased. The area of the fracture site and the volume of the herniated orbital tissue that caused enophthalmos of 2 mm were 1.9 cm2 and 0.9 ml, respectively. CONCLUSION: In BOF of the medial orbital wall, surgical intervention may be recommended to prevent significant enophthalmos when the area of fracture site is 1.9 cm2 or more, or the volume of herniated orbital tissue is 0.9 ml or more.

The Use of Miniplates for Treatment of Mandibular Fractures / 대한이비인후과학회지

BACKGROUND: The mainstay of treating mandibular fracture is adequate reduction and fixation. Recently, miniplate fixation of mandibular fractures is commonly used due to the rapid bone healing, short duration of maxillomandibular fixation, improved oral intake, and decreased postoperative complications. OBJECTIVE: This study presents the results of treating fractures of the mandible using miniplates. MATERIALS AND METHODS: Among 144 patients treated for fractures of the mandible within a six-year period, 99 patients treated with miniplates were retrospectively studied for etiologies, associated injuries, sites of fractures, postoperative results and complications. RESULTS: All fractures were found to be stable at follow-up and there were no serious postsurgical complications. CONCLUSION: Open reduction and internal fixation with miniplate is a reliable and effective technique for the treatment of mandibular fractures.